Background

In June 2003, EMERGENCY opened a Maternity Centre in Anabah, Afghanistan, to provide antenatal, gynaecological, obstetric, and neonatal care to the population of the Panjshir Valley and the surrounding provinces. In 2015, the Maternity Centre underwent an expansion, improving its facilities and increasing the number of beds. The expanded Maternity Centre opened in 2016, and 2017 saw the completion of its first full calendar year. Despite initial concerns from local authorities that the facility might stay empty, the excellent standard of healthcare provided by our dedicated local and international team has won the trust of people across the country; and convinced many of the importance of specialised healthcare in a country with one of the highest maternal and infant mortality rates in the world. The maternal mortality rate amounts to around 400 deaths per 100,000 live births.

Since opening, the Anabah Maternity Centre has provided care for more than 500,000 women and delivered over 63,000 babies. These numbers increase daily. The centre saw an average of 554 births every month during 2019. 7,873 women were admitted in 2019 (compared to 7,582 in 2016); the number of new-borns delivered was 6,655 (6,380 in 2016), with over 33,000 pre-natal check-ups performed.

The New Facility

By 2015, the Anabah Maternity Centre was delivering over 500 births a month and had become too small to meet the increasing demand for maternal healthcare from both local women and the 77% of patients who visit us from outside the province. In September of 2015, we therefore made the decision to enlarge the Maternity Centre by building a new block with 4 delivery rooms; operating theatres; a neonatal intensive care ward and step-down unit; an intensive care unit for women suffering birth complications; a clinic; a gynaecology ward; a follow-up area; and labour area. The centre also runs an antenatal programme aimed at monitoring pregnancies in order to promptly identify complications. For an overall cost of €1.5m, various professionals and technicians from both Afghanistan and Europe constructed a state-of-the-art facility capable of providing care for more than 600 women per month, 7,000 deliveries a year, and more extensive gynaecological and neonatal services. The expanded Maternity Centre opened on 8 December 2016. 

With the consent of her family, the new centre is dedicated to Valeria Solesin, an EMERGENCY volunteer who was killed during the Bataclan attacks in Paris on November 13, 2015.

On the day of the inauguration, Ferozuddin Feroz, Afghanistan’s Minister of Public Health said: “The maternal mortality ratio in Afghanistan is extremely high, at a rate of about 325 per 100,000 live births. Establishing this kind of specialised maternity hospital that cares for mother and child is really contributing to the reduction of maternal mortality in Afghanistan.”

Dominic Parker, from the United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA), added: “One of the biggest concerns we have as a humanitarian community is the high maternal mortality rate, with women dying during childbirth or shortly after. The figures are getting worse and that is why this state-of-the-art centre with its modern equipment and specialised neonatal facilities is crucial to saving the lives of women and children.”

“Panjshir was the first place in Afghanistan where an EMERGENCY facility opened, with the construction of its surgical centre taking place in 1999”, says Rossella Miccio, President of EMERGENCY. “Seventeen years later we have treated over 3 million patients and today we are inaugurating a new building for the women of Panjshir Valley and the surrounding areas.”

A beautiful natural birth marked the opening of the Maternity Centre’s new building. 

“Opening the hospital with a birth like this one bodes quite well!” says Eleonora Bruni, Medical Coordinator at the centre. “All of us from the international and local staff are happy because this new structure is truly beautiful. At the same time, we will always be quite attached to the old building that, in 2003, hosted the very first Maternity Centre in the history of Panjshir. Today, the transfer of all assets and activities from the old centre to the new one has been completed. The new centre has enabled EMERGENCY to double the capacity of beds and – thanks to the new delivery rooms, operating theatres, and ICU – improve care for women and infants in the valley. Thanks to everyone who helped make this new project possible.”

Always Open, Always Free

Although Afghanistan’s extremely high infant and maternal mortality rates have begun to improve, the Anabah Maternity Centre remains the only specialised and completely free facility in an area with a population of at least 250,000 people. It is open 24/7 and works alongside our network of First Aid Posts (FAPs) and Primary Health Clinics (PHCs) spread throughout the Panjshir Valley and the surrounding areas, to ensure as many women as possible have access to its services. These First Aid Posts and Primary Health Clinics also ensure that patients and their new-born babies, who travel from outside Panjshir, can receive check-ups and follow-up examinations closer to home. FAPs and PHCs provide prenatal care, contraception, and screening for gynaecological diseases. Patients who visit them may also be transferred to the main Maternity Centre by EMERGENCY’s ambulances, which operate around the clock. In 2019, 320,015 consultations were performed in the FAPs and PHCs, and over 480 of these were women in labour referred to EMERGENCY’s Maternity Centre.

The Anabah project is more than just a medical facility, however, and was founded with the aim of offering support to both local women and those from across the region – in a society where inequality between the sexes is still significant. Providing access to quality maternity care is one way in which the centre tries to achieve this, but EMERGENCY is also aware that there are many women who, due to cultural or personal preferences, still wish to give birth at home. Because of this, in late 2005, a Childbirth Education Programme was initiated, facilitating the distribution of sanitary kits to improve hygiene and prevent infection.

More Than Just A Hospital: Training and Employing Women

The Maternity Centre in Anabah also works to support women through education. Local women are provided with the opportunity to receive theoretical and practical medical training. As of 2020, the facility employs 166 local staff, many of whom have been trained at the centre. The Maternity Centre is recognised by the Afghan Ministry of Health as a national training centre for specialisation in paediatrics and gynaecology. 70 members of staff are continuing their training in obstetrics and nursing, and a further 25 continue to maintain hygiene standards. Training for young female Afghan doctors also continues: we have already trained two gynaecologists who are now working in the national healthcare system. Three current trainees are now finishing their second year of specialisation and one is finishing her first. Our operating theatre is open for training to the young surgeons who occasionally come from our hospitals in Kabul and Lashkar-Gah. This programme is crucial, as wounded pregnant women often arrive at our facilities in war-torn areas.

“There have been many wars in Afghanistan and women have suffered a lot. Now, they want to learn new things, they want to be educated and become professionals. I think that the merits of EMERGENCY’s Maternity Centre go beyond the surgical and medical treatment provided to an area inhabited by more than 1 million people. For women in our region, the Maternity Centre has become a symbol and place of emancipation. Here they now have the chance to work, to receive a high standard of training, and to have a role and a status within their communities that goes beyond being a wife or a mother.”

– Marja, Coordinator of the national midwifery team in Anabah, Afghanistan

Marja’s Story